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Arthroscopic-assisted Arthrodesis of the Knee Joint With the Ilizarov Technique

View Article: PubMed Central - PubMed

ABSTRACT

Arthrodesis of the knee joint is a mainly a salvage surgical procedure performed in cases of infected total knee arthroplasty, tumor, failed knee arthroplasty or posttraumatic complication.

The authors report the case of 18-year-old male with posttraumatic complication of left knee because of motorbike accident 1 year before. He was treated immediately after the injury in the local Department of Orthopaedics and Traumatology. The examination in the day of admission to our department revealed deformation of the left knee, massive scar tissue adhesions to the proximal tibial bone and multidirectional instability of the knee. The plain radiographs showed complete lack of lateral compartment of the knee joint and patella. The patient complained of severe instability and pain of the knee and a consecutive loss of supporting function of his left limb. The authors decided to perform an arthroscopic-assisted fusion of the knee with Ilizarov external fixator because of massive scar tissue in the knee region and the prior knee infection.

In the final follow-up after 54 months a complete bone fusion, good functional and clinical outcome were obtained.

This case provides a significant contribution to the development and application of low-invasive techniques in large and extensive surgical procedures in orthopedics and traumatology. Moreover, in this case fixation of knee joint was crucial for providing good conditions for the regeneration of damaged peroneal nerve.

No MeSH data available.


Two years after the surgery. The patient returned to work.
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Figure 12: Two years after the surgery. The patient returned to work.

Mentions: The surgery began with an arthroscopy. A complete lack of the lateral femoral and tibial condyle and lateral meniscus were observed. The anterior cruciate ligament was not found either. A proliferated inflamed synovium was noted in the joint. On the medial condyle of the femoral bone, signs of chondromalacia with the lesion of I°/II° in the weight-bearing region were observed. The inflamed synovium was then removed using a shaver and bipolar electrode. Next, with the use of a cochlea and the shaver, the articular cartilage was removed from the medial condyle of femoral bone, revealing the subchondral layer with signs of slight bleeding. A similar procedure was performed on the medial tibial plateau. Next, a total medial meniscectomy was performed. Fluoroscopy was used as guidance to fix the Ilizarov external fixator, with the knee flexed in 15° (Figure 4). At the end of the procedure, an autologous growth factor was administered to the knee (Gravitational Platelet Separation III System, Biomet Biologics, Inc. Warsaw, Indiana, USA). During the 2-week period after the operation, flexion of the knee was changed to 30° at the request of the patient; being a taxi driver, he needed to remain in sitting position during work (Figure 12).


Arthroscopic-assisted Arthrodesis of the Knee Joint With the Ilizarov Technique
Two years after the surgery. The patient returned to work.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998273&req=5

Figure 12: Two years after the surgery. The patient returned to work.
Mentions: The surgery began with an arthroscopy. A complete lack of the lateral femoral and tibial condyle and lateral meniscus were observed. The anterior cruciate ligament was not found either. A proliferated inflamed synovium was noted in the joint. On the medial condyle of the femoral bone, signs of chondromalacia with the lesion of I°/II° in the weight-bearing region were observed. The inflamed synovium was then removed using a shaver and bipolar electrode. Next, with the use of a cochlea and the shaver, the articular cartilage was removed from the medial condyle of femoral bone, revealing the subchondral layer with signs of slight bleeding. A similar procedure was performed on the medial tibial plateau. Next, a total medial meniscectomy was performed. Fluoroscopy was used as guidance to fix the Ilizarov external fixator, with the knee flexed in 15° (Figure 4). At the end of the procedure, an autologous growth factor was administered to the knee (Gravitational Platelet Separation III System, Biomet Biologics, Inc. Warsaw, Indiana, USA). During the 2-week period after the operation, flexion of the knee was changed to 30° at the request of the patient; being a taxi driver, he needed to remain in sitting position during work (Figure 12).

View Article: PubMed Central - PubMed

ABSTRACT

Arthrodesis of the knee joint is a mainly a salvage surgical procedure performed in cases of infected total knee arthroplasty, tumor, failed knee arthroplasty or posttraumatic complication.

The authors report the case of 18-year-old male with posttraumatic complication of left knee because of motorbike accident 1 year before. He was treated immediately after the injury in the local Department of Orthopaedics and Traumatology. The examination in the day of admission to our department revealed deformation of the left knee, massive scar tissue adhesions to the proximal tibial bone and multidirectional instability of the knee. The plain radiographs showed complete lack of lateral compartment of the knee joint and patella. The patient complained of severe instability and pain of the knee and a consecutive loss of supporting function of his left limb. The authors decided to perform an arthroscopic-assisted fusion of the knee with Ilizarov external fixator because of massive scar tissue in the knee region and the prior knee infection.

In the final follow-up after 54 months a complete bone fusion, good functional and clinical outcome were obtained.

This case provides a significant contribution to the development and application of low-invasive techniques in large and extensive surgical procedures in orthopedics and traumatology. Moreover, in this case fixation of knee joint was crucial for providing good conditions for the regeneration of damaged peroneal nerve.

No MeSH data available.